Leukemia: Nutritional Considerations

The body of scientific literature addressing the role of diet in leukemia risk is considerably smaller than for solid tumors. Epidemiologic evidence suggests that the following factors are associated with reduced risk, although all require further study.

Reducing or Eliminating Meat Consumption

The risk for leukemia attributable to meat, particularly processed meat, may be related to the intake of nitrates used as preservatives; these become highly carcinogenic N-nitroso compounds. Evidence indicates that children eating more than 12 hot dogs per month have 9 times the normal risk of developing childhood leukemia, and that a strong risk for childhood leukemia also exists for those children whose fathers eat 12 or more hot dogs per month.¹ A higher-than-average meat intake was also found in a study of over 13,000 male Iowa farmers who experienced a 25% greater risk for leukemia, compared with individuals who were not farmers and consumed less meat.²

High Vegetable and Fruit Intake

The risk for leukemia in adult women is inversely associated with vegetable intake,³ and increased maternal intake of fruits and vegetables is associated with reduced risk of childhood ALL.^4,5 Regular intake of oranges, orange juice, and bananas is also associated with roughly a 50% reduction in leukemia risk among children 2 to 14 years old.⁶

Breast-feeding

Short-term (< 6 months) and longer-term (> 6 months) breast-feeding is associated with reduced risk for childhood leukemias by 15% to 24%.⁷

Healthy Body Weight

Women who are overweight or obese have a 61% to 90% greater risk for leukemia than women of normal weight.^8,9 The obesity-leukemia relationship may be due to excess energy intake.^2,10 Among the hypothesized mechanisms are genetic polymorphisms in enzymes that reduce the oxidative stress brought on by excess calorie intake.¹¹ Avoidance of obesity may be especially important for pregnant women, because excess maternal weight gain is a known risk factor for macrosomia, a condition associated with a greater risk for infant leukemia.¹² Being overweight or underweight also reduces survival in children with acute myelocytic leukemia.¹³

Avoiding Alcohol

Maternal alcohol intake during pregnancy raises the risk of both ALL and AML in children.^{14, 15}

Orders

See Basic Diet Orders chapter.

What to Tell the Family

Leukemias make up a family of blood cancers that have highly variable courses and treatment. Acute leukemias are rapidly fatal without treatment, but may be curable with aggressive treatment. Chronic leukemias can be slow growing; CLL may not need initial treatment, and CML can usually be controlled with oral therapy for years. Bone marrow transplantation is often considered for patients less than 55 years of age.

Available evidence suggests a role for diet in preventing several types of leukemia.